…by the Editors of the New England Journal of Medicine
Covid-19 has created a crisis throughout the world. This crisis has produced a test of leadership. With no good options to combat a novel pathogen, countries were forced to make hard choices about how to respond. Here in the United States, our leaders have failed that test. They have taken a crisis and turned it into a tragedy.
The magnitude of this failure is astonishing. According to the Johns Hopkins Center for Systems Science and Engineering,1 the United States leads the world in Covid-19 cases and in deaths due to the disease, far exceeding the numbers in much larger countries, such as China.
The death rate in this country is more than double that of Canada, exceeds that of Japan, a country with a vulnerable and elderly population, by a factor of almost 50, and even dwarfs the rates in lower-middle-income countries, such as Vietnam, by a factor of almost 2000. Covid-19 is an overwhelming challenge, and many factors contribute to its severity. But the one we can control is how we behave. And in the United States we have consistently behaved poorly.
Why has the United States handled this pandemic so badly? We have failed at almost every step. We had ample warning, but when the disease first arrived, we were incapable of testing effectively and couldn’t provide even the most basic personal protective equipment to health care workers and the general public. And we continue to be way behind the curve in testing.
While the absolute numbers of tests have increased substantially, the more useful metric is the number of tests performed per infected person, a rate that puts us far down the international list, below such places as Kazakhstan, Zimbabwe, and Ethiopia, countries that cannot boast the biomedical infrastructure or the manufacturing capacity that we have.2 Moreover, a lack of emphasis on developing capacity has meant that U.S. test results are often long delayed, rendering the results useless for disease control.
Although we tend to focus on technology, most of the interventions that have large effects are not complicated. The United States instituted quarantine and isolation measures late and inconsistently, often without any effort to enforce them, after the disease had spread substantially in many communities.
Our rules on social distancing have in many places been lackadaisical at best, with loosening of restrictions long before adequate disease control had been achieved. And in much of the country, people simply don’t wear masks, largely because our leaders have stated outright that masks are political tools rather than effective infection control measures. The government has appropriately invested heavily in vaccine development, but its rhetoric has politicized the development process and led to growing public distrust.
The United States came into this crisis with enormous advantages. Along with tremendous manufacturing capacity, we have a biomedical research system that is the envy of the world. We have enormous expertise in public health, health policy, and basic biology and have consistently been able to turn that expertise into new therapies and preventive measures. And much of that national expertise resides in government institutions. Yet our leaders have largely chosen to ignore and even denigrate experts.
The response of our nation’s leaders has been consistently inadequate. The federal government has largely abandoned disease control to the states. Governors have varied in their responses, not so much by party as by competence. But whatever their competence, governors do not have the tools that Washington controls. Instead of using those tools, the federal government has undermined them.
The Centers for Disease Control and Prevention, which was the world’s leading disease response organization, has been eviscerated and has suffered dramatic testing and policy failures. The National Institutes of Health have played a key role in vaccine development but have been excluded from much crucial government decision making. And the Food and Drug Administration has been shamefully politicized,3 appearing to respond to pressure from the administration rather than scientific evidence.
Our current leaders have undercut trust in science and in government,4 causing damage that will certainly outlast them. Instead of relying on expertise, the administration has turned to uninformed “opinion leaders” and charlatans who obscure the truth and facilitate the promulgation of outright lies.
Let’s be clear about the cost of not taking even simple measures. An outbreak that has disproportionately affected communities of color has exacerbated the tensions associated with inequality. Many of our children are missing school at critical times in their social and intellectual development. The hard work of health care professionals, who have put their lives on the line, has not been used wisely.
Our current leadership takes pride in the economy, but while most of the world has opened up to some extent, the United States still suffers from disease rates that have prevented many businesses from reopening, with a resultant loss of hundreds of billions of dollars and millions of jobs. And more than 200,000 Americans have died. Some deaths from Covid-19 were unavoidable.
But, although it is impossible to project the precise number of additional American lives lost because of weak and inappropriate government policies, it is at least in the tens of thousands in a pandemic that has already killed more Americans than any conflict since World War II.
Anyone else who recklessly squandered lives and money in this way would be suffering legal consequences. Our leaders have largely claimed immunity for their actions. But this election gives us the power to render judgment. Reasonable people will certainly disagree about the many political positions taken by candidates. But truth is neither liberal nor conservative.
When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent.
We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs.
Disclosure forms provided by the authors are available with the full text of this editorial at NEJM.org.
Dangerously Incompetent’: US Medical Journal castigates Trump administration over COVID-19 response
…from Sputnik News, Moscow
A scathing editorial in the prestigious (NEJM) claims the COVID-19 novel coronavirus pandemic has tested the current US administration and that “our leaders have failed that test.”
“Why has the United States handled this pandemic so badly?” asks the editorial, signed by 35 editors, 34 of whom are American citizens, according to the New York Times.
“We have failed at almost every step. We had ample warning, but when the disease first arrived, we were incapable of testing effectively and couldn’t provide even the most basic personal protective equipment to health care workers and the general public.”
Along with being the oldest continuously published medical journal, the NEJM is also regarded as one of the most prestigious peer-reviewed medical publications.
The editorial does not mention US President Donald Trump by name, but notes that “our leaders” in the US have “taken a crisis and turned it into a tragedy.”
“When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent,” the editorial states.“It should be clear that we are not a political organization,” said Dr. Eric Rubin, the editor-in-chief of the NEJM, to the Times. “But pretty much every week in our editorial meeting there would be some new outrage.”
At the same time, the journal did not announce an explicit endorsement for Democratic presidential nominee and former US Vice President Joe Biden.
American popular science magazine Scientific American, which has been around for 175 years, announced on September 15 that it felt “compelled” to make its first-ever endorsement of a presidential candidate, coming out in favor of Biden.
The publication also directly spoke of the US president and his approach to science.
“The evidence and the science show that Donald Trump has badly damaged the US and its people – because he rejects evidence and science,” the magazine’s editors wrote.
“The most devastating example is his dishonest and inept response to the COVID-19 pandemic, which cost more than 190,000 Americans their lives by the middle of September,” they said. On Wednesday, the death toll was more than 211,000, according to data collected by the Times.
Trump’s opposition to science has been on full display since he was discharged from Walter Reed National Military Medical Center on Monday.
“Now I’m better, and maybe I’m immune,” he said, speaking of his recent diagnosis of COVID-19 in a video published via his personal Twitter account. Upon his return to the White House, he told Americans not to let the virus “dominate” them, adding, “Don’t be afraid of it.”